Multi-action stationary exercise device

ABSTRACT

An exercise device combining upper and lower body in synchronized movements to encourage neurological development, rehabilitation, learning and orthopedic rehabilitation in children and adults in every situation where appropriately modified stationary exercise equipment can be placed. The exercise device includes a frame; left and right arm assemblies, each supported by the frame and configured to enable pivoting movement relative to the frame; left and right leg assemblies, each supported by the frame and configured to enable rotational movement about a central pivot axis; a drive mechanism supported by the frame and configured to enable contralateral movement of the left arm assembly relative to the right leg assembly, and of the right arm assembly relative to the left arm assembly; where the left and right arm assemblies are adjustable to enable use of the exercise apparatus in both an upright seating configuration and a recumbent seating configuration.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is based on and claims priority to U.S. Provisional Application No. 61/612,650, filed Mar. 19, 2012, the entire contents of which is hereby incorporated fully by reference.

BACKGROUND OF THE INVENTION

1. Field of the Invention

This invention relates to stationary exercise cycles, and specifically to such equipment as having dual action reciprocally-related lever arms and pedals, adjustable lever aims and pedal crank aims, a boom-like moveable reading platform, and vertical and recumbent riding options.

2. Brief Description of the Prior Art

Corbalis et. al. (U.S. Pat. No. 7,736,281) describe a platform on the front of their invention to hold reading materials which is moveable in a single dimension, forward and backward. This device is clearly intended to facilitate reading while exercising and does not permit therapeutic-effective placement of the head or reaching activities with either hand.

Howell et. al. (U.S. Pat. No. 6,902,515) describe a device for upper extremity exercise which attaches to the back of the seat mount and extends over the head, presenting a set of pedals and resistance device (ergometer) in front of the user. While this invention contains elements of a boom, its purpose is not to present digital and print media and enable therapeutic placement of the head and therapeutic exercise of either upper extremity including cross-body reaching.

Neither NuStep, SciFit, nor Biodex recumbent/semi-recumbent ergometers include the moveable boom in the specification sheet, description, or options list.

Hildebrandt et al (U.S. Pat. No. 7,775,942) describe extendable upper arms and integrated rotatable handles. The handles are limited to +/−30 degrees rotation. (NuStep). There is no mention of altering the elevation of the upper arm assembly.

U.S. Pat. No. 7,108,641 (assigned to Schwinn) describes a pair of arms not connected to a pedal or any rotating subassembly, and fastened behind the user. Again, there is no mention of altering the elevation of the upper arm assembly.

Fitness stationary bike manufacturers do not offer adjustable crank arm lengths. Equipment for the physical therapy market, such as the SciFit Pro 2 bike, offer various proprietary means of changing the pedal crank arm length. The SciFit system is fully different from the invention described herein.

Dwight, in U.S. Pat. No. 4,673,178, describes an adjustable-length pedal crank arm consisting of a two-piece crank+clamp arm, where the clamp arm is notched on the inside surface, a sliding pedal block, and a protrusion on the pedal block that seats in the notch. The clamp arm is hinged at the proximate or axle end of the assembly; the distal end is captured with a mechanism that allows it to be removed and swung away from the crank arm to permit moving the sliding pedal block and afterwards is pushed into place and secured to clamp the pedal block in its new position. Its complexity does not favor manufacturing. The clamp arm, by virtue of slot cut into it for the sliding pedal block, may present the opportunity of being deformed if not securely fashioned.

While vertical, semi-recumbent, and recumbent riding positions are available in commercial single action stationary exercise bikes, and inventions that describe combinations are described in the patent literature (U.S. Pat. No. 6,926,645B, U.S. Pat. No. 47,579,888A), a dual-action bike which can be converted between vertical and recumbent riding positions is not available. Not only does the spatial relationship of the rider to the pedals change but the elevation and length of the bike's lever arms must be significantly modified to permit the longer reach required for recumbent position riding.

Stearns and Maresh (U.S. Pat. No. 6,926,645) describe a cycle with lever arms and foot pedals that is convertible through the range of vertical to full recumbent riding, by modifying the seat position while still connected to the frame. Their lever arms are vertical and fixed to the seat, not synchronized with the pedals, so they move as the seat is repositioned with respect to the pedals. Further, the seat remains connected to the frame, thus requiring the rider to step over the device. The proposed apparatus cannot be used by a person sitting in a wheelchair or not able to step over an obstacle.

Szymski (U.S. Pat. No. 4,757,988) combines two separate embodiments, one with a complex linkage between pedals, fixed length and position vertical lever arms, fan, and seat to demonstrate semi-recumbent riding, and one with similar principles for vertical riding, two separate devices.

Dual-action stationary exercise equipment engages both the upper and lower extremities. There are apparently therapeutic and physiological advantages to moving both the upper and lower extremities (Neurodevelopmental Treatment NDT in Adult Hemiplegia: Evaluation and Treatment, by Berte and Karel Bobath 1990), although not all equipment allows synchronized adjustable movement of both the upper and lower extremities and some equipment may actually produce incorrect reciprocal movements of the limbs (see Hooper, U.S. Pat. No. 4,188,030A, FIG. 3).

The lower extremities can extend and flex in response to a rotational Movement—the pedals on vertical bike—or variations of back-and-forth movement of an elliptical machine, stepper (e.g., NuStep®), cross-trainer, or strider (e.g., Nordic Trac®). There are also of specific pieces of equipment for rehab patients who are in bed or restricted to wheelchairs such as Bannister et.al. (U.S. Pat. No. 4,976,426), Chen (U.S. Pat. No. 4,993,407), and Hirschfeld (U.S. Pat. No. 5,033,736).

The upper extremities can move in circles as with the ergometers, back-and forth over a wide arc as with lever arms, and up-and-down as with overhead pulleys specifically for shoulder rehab.

The dual-action ergometers may link the upper and lower extremity rotating movements.

Examples of the dual-action lever-arm stationary exercise bikes on the market today include the following:

-   1. Vision Fitness E4000 -   2. Sears Marcy -   3. Schwinn Airdyne models -   4. Stamina Air Resistance Upright -   5. Star Trac Airbike AF -   6. Gold's Gymn Whirlwind 390 -   7. Zephyr Stairmaster -   8. eVo by Therapy Motions.

Item 1 uses a magnetic brake to increase resistance, item 8 is motorized, and the remainder employ a fan. Not all engage the pedals and lever arms in the same manner. Except for no. 8, these are all fitness equipment and have rigid, one-piece lever arms. Item 8 is designed for therapy and has extendible arms and rotatable handles, and is motorized to provide passive assisted motion.

SUMMARY OF THE INVENTION

This invention relates to combining upper and lower body in synchronized movements to encourage neurological development, rehabilitation, and learning in children and adults in every situation where appropriately modified stationary exercise equipment can be placed. The invention can also be applied to early-stage orthopedic rehabilitation to permit the patient's own control of the rate and degree of flexing of the convalescing knee by using the extended recumbent mode lever arms to move the knee backward and forward and controlling full pedal rotation.

Some claims focus on the dual-action lever-arms as they permit a range of synchronized motions not available in systems that permit only rotational movement of the upper extremities.

BACKGROUND Physical Neurological Therapy

Reciprocal creeping (four-point crawling) and other neuro-developmental patterns have been used in the remediation of developmental and acquired neurological disorders. (See Neurodevelopmental Treatment (NDT) in Adult Hemiplegia: Evaluation and Treatment, by Berte and Karel Bobath 1990) The synchronized movement patterns of both upper and lower extremities in a creeping pattern made possible using the claimed invention at differing speeds allow NDT principles to be applied at “game speed” (the speed that they would be used in normal life). This capability combined with the measured adjustability of the modifications in the claimed invention in several different planes for both upper and lower extremities make it unique in its application as a neuro-rehabilitation tool. One example of the adjustability of the arms of the claimed invention is when the right handle is oriented vertically and the entire arm assembly is rotated inward toward the center line of the bike to permit a person with mild to moderate left-side hemiplegia to cross midline with his/her left hand and hold the handle to execute many repetitions of a forward/backward motion. Alternatively, the boom can be adjusted to position the media tray above the rider's head or to one side to “force” the rider to reach repetitively to touch media, such as when playing a game on a touch screen tablet.

The “reciprocal” motion of the claimed invention is described thusly: The elbow on one side of the body is straightened in the forward stroke (shoulder extends) as the knee on the other side is likewise straightened (hip extends) in the downward pedal stroke, as the other set of limbs is flexed at the elbow and knee or, the arm and leg on opposite sides are pushing forward and down (hip and shoulder extending), respectively, as the other arm is pulling back and the other leg is being carried up to the top of the pedal stroke.

In addition to the adjustability of the handles, pedal arm, and boom, several different grades of therapeutic exercise are possible in combination or isolation because of the basic magnetic resistance brake of the claimed invention. Passive (therapist completes the movement for the patient by holding and moving the lever arms), active assisted (partial assistance by a therapist to complete the movement), active (total voluntary movement by the rider), and resisted (magnetic resistance increased) are all possible within seconds of each other within the same exercise session using the claimed invention. With input of an rpm sensor (wireless or wired) connected to a computer or personal computing device or smart phone, timing and rhythm training can be added along with NDT techniques using the claimed invention. Rhythm and timing are key components of another effective neurological treatment technique, “Interactive Metronome” (McGrew, Kevin S; Taub, Gordon; Keith, Timothy Z. (2007)). The claimed invention also permits the massed practice, constraint, and limited shaped therapies described by E. Taub, et. al. (2002) in constraint-induced movement therapy for stroke and TBI.

The possibility of combining these and other existing effective treatment techniques make a stationary exercise bike modified to conform to the claimed invention described herein an effective treatment option in neurological and orthopedic rehabilitation.

The claimed invention provides a means of guiding adults and children to perform appropriate neuro-developmental movements to decrease the influence of immature neurological reflexes and inappropriate patterns induced by stroke or other brain trauma. It is further the object of the claimed invention to give therapists a tool with a wide range of adjustability in the arms, pedals, and sitting/riding position that allows different therapies to be given to patients of different sizes and with varying needs, including orthopedic rehabilitation and preventive therapeutic exercise.

The invention provides a pair of lever arms with five modes of adjustment, thereby enabling certain of the above-described benefits.

A section of the lower arm inserted in a sleeve allows the entire arm to be raised or lowered at least 2-4 inches, and rotated about the long axis of the vertical sleeve inward towards the center of the frame or outwards away from the frame, after the quick-release clamp is loosened.

The claimed invention further provides a hinge with locking adjustments every 10 degrees installed between the lower and upper arm assemblies that permits the handle elevation to be altered in an arc comprising 220 degrees. The hinge surfaces are marked with a relative scale and marker to indicate the position of the hinge for repeatable positioning of the angle of the arms.

The claimed invention further provides an arm having a length that can be adjusted to fit the size of the patient or nature of the therapy by use of a telescoping member inside the upper hinge armature sleeve. In this embodiment the length is determined by free translational movement of the telescoping element in the upper armature sleeve after a quick-release clamp in the upper armature sleeve is loosened. The change from vertical to recumbent riding is accomplished by replacing a shorter, vertical arm with the longer, recumbent arm.

The claimed invention further provides 360° rotation of the handles around the long axis of the telescoping member after loosening the quick-release clamp in the upper armature sleeve.

Another purpose of the claimed invention is to provide a mechanism whereby the pedal crank arm length can be adjusted by use of a sliding block, including a means of securing that block to the crank arm.

Another purpose of the claimed invention is to provide a means of riding the bike in either the vertical position or the recumbent position. The recumbent position utilizes a means of lengthening the arms. A wheelchair can be rolled to the back and secured with its wheel locks. A seat or chair can also be secured to a plate which is attached to the back foot of the bike, preventing the forward horizontal motion of the bike or the reverse horizontal movement of the chair as the rider pushes on the pedals from a near horizontal position, and the rotation (lifting) of the back of the bike and the rotation (lifting) of the front of the chair in response to the vertical component of the force the rider exerts on the pedals.

The claimed invention further provides a method for presenting print, digital,l of any type of media to the rider. The media are carried on a tray which can be moved about at least three axes and raised and lowered sufficiently to make fine adjustments for its placement. The tray is further supported at the end of a telescoping element that permits extension of length and rotation about the long axis of the extensible element with several embodiments of the means of fixing it in place, including a quick-release clamp. Further, the tray can be raised through an arc of 220 degrees by use of a hinge connected to the opposite end of the extensible element. The tray-arm assembly can also be rotated 360 degrees about the vertical axis of the mounting point on the front of the frame and fixed in place by several embodiments, including a quick-release clamp.

The claimed invention further provides a means of controlling aspects of the digital media by the speed of the rotation of the pedals. Among these aspects are the relative visibility of the screen, the relative strength of the audio signal, and control of the left-right motion and apparent forward-backward motion of mobile elements in various embodiments of software.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a side view of the 5-mode adjustable articulated arm.

FIG. 2 is a side view of the boom which is attached to the front mast of the frame. It is an articulated arm similar to the lever arms, and carries the media tray at the end.

FIG. 3 shows the media tray which allows substantial adjustment of the position of the media. It is mounted on the end of the boom.

FIG. 4 shows how the length of the pedal arm is changed by sliding a block along the pedal crank arm. The pedal is mounted in the sliding block.

FIG. 5 is an example of a recumbent riding system which includes a platform bolted to the back foot of the bike and a means to keep the chair from sliding backwards and from lifting up.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

In FIG. 1 is shown the articulated lever arm 100. It is composed of the upper arm assembly 110 and the lower arm assembly 150 joined by the hinge 180, the purpose of which is to provide a sufficient range of adjustability to fit a wide range of patient size and specific therapies.

The hinge 180 joins the lower 150 and upper arm assemblies by fixing its two armatures, 181 and 185, respectively to the lower and upper arm assemblies. The hinge provides elevation of the upper arm assembly in 10 degree increments through a range of 220 degrees to permit fine adjustments and a variety of therapies from both the seat area and the front of the bike.

The lower arm assembly 150 is composed of the lower arm 151, lower armature sleeve 156, and the lower armature 181 of the hinge 180. The lower arm 151 is linked to the pedals by various means that are not the subject of this invention. A quick-release clamp 157 added to the top of the lower arm 151 permits free translational and rotational movement of the entire lever arm above it and secures the arm from moving on these axes.

The lower armature sleeve 156 slides into the lower arm as a minimally telescoping element (at least 2″-4″). The top is screwed to the hinge lower armature sleeve 181.

The upper arm assembly 110 is composed of the upper armature sleeve 111 which is screwed to the hinge upper armature 185. Telescoping element 116 constitutes the extendible and rotatable arm. In this embodiment it is short enough to be used for vertical riding, in another embodiment 117 it is lengthened for recumbent riding. Register rings are cut into the end of the arm to assist the therapist and rider set the arms and consistent and known extension lengths.

In one embodiment a quick-release clamp 112 is added to the upper armature sleeve 111 to permit free translational movement of the telescoping element 116 and to secure it against movement.

In one embodiment the telescoping element 116 is bent to provide the handle 120. In that embodiment the handle can be rotated to the desired angle among 360° by loosening and tightening the quick-release clamp 112.

In FIG. 2 is shown the articulated boom arm 200. It is essentially similar to item 100, and is composed of the upper arm assembly 210 and the lower arm assembly 250 joined by the hinge 280, the purpose of which is to provide a sufficient range of adjustability to allow print or digital media to be presented to the rider in a variety of positions that help locate the head for therapeutic benefit, for cross-body reaching movements, and for closeness and ease of access to the digital media.

The hinge 280 joins the lower 250 and upper arm assemblies by fixing its two armatures, 281 and 285, respectively to the lower and upper arm assemblies. The hinge provides elevation of the upper arm assembly in 10 degree increments through a range of 220 degrees to ensure the media tray is correctly positioned and safely clears the lever arms. In another embodiment the hinge could be replaced with flexible tubing (“gooseneck”).

The boom lower arm assembly 250 is composed of the lower arm 251, lower armature sleeve 256, and the lower armature 281 of the hinge 180. A quick-release clamp 257 added to the top of the lower arm 251 permits free rotational movement of the entire articulated boom arm and prevents movement when it is tight to permit the rider to interact with the media on the media tray without the tray moving.

The lower armature sleeve 256 is fitted into the lower boom arm. The top is screwed to the hinge lower armature sleeve 281.

The upper arm assembly 210 is composed of the upper armature sleeve 211 which slides over and is screwed to the hinge 281 upper armature 285. Telescoping element 216 constitutes the extendible and rotatable arm.

In one embodiment a quick-release clamp 212 is added to the upper armature sleeve 211 to permit free translational and rotational movement of the telescoping element 216 and to secure it.

The media tray 220 is shown in FIG. 3. It consists of a plate 221 welded to the extendible arm 216. The clamp 222 is screwed to the plate and the polycarbonate tray. A j-channel 223 is affixed to the bottom of 224 as a lip to hold the media on the tray. Media can be secured to the tray by various means, including “Velcro®, non-slip fabric, rubber bands, and magnets.

In FIG. 4 is shown a method for changing the pedal crank arm effective length, useful for adapting the bike to riders of varying size and rehabilitation requirements. The adjustable pedal block 310 and custom crank arm 350 are illustrated.

The adjustable pedal block 310 is composed preferably of steel or other suitable and compatible material, configured with a hole or gap 317 to fit the modified crank arm 350. A spring pin 315 and a set screw 316, in one embodiment, secure the crank arm. Another embodiment drills the holes 360 through the crank arm so a positive locking, quick-release pin can be inserted to secure the block to the crank arm. The block 311 can be one piece or an assembly where several parts are joined by welding or gluing, or mechanically with bolts. Different means of connecting the pedal to the block are possible, depending on the means of linking the pedal and lever arm motion in the base bike

The crank arm 350 is composed of the body 355 which fits the gap 317 in the adjustable pedal block 310. It is fit to the drive unit's axle at 356 by various means, including friction fit and quick-release methods. Holes 360 are drilled in the top of the crank arm 355 at regular intervals permitting the length of the crank arm to be set at various therapeutically important lengths between 3″ and 6″. Additionally, the holes are drilled 2-4 centimeters deep according to the length of the spring pin 315 and with an inner diameter to ensure snug fit of the pin. In another embodiment the holes can be drilled through the crank arm and a removable locking quick-release pin can locate and hold the sliding block to the crank arm.

In FIG. 5 is shown a recumbent riding platform 400 in one embodiment, specifically where 410 represents the back foot of the bike and the locking pin block 430 is mounted on the top surface of the foot but off center. A hole matching the diameter of the spring pin 431 is drilled into the end of the stabilizing rod, 433, such that the end of the rod is flush with the back side of the block 430 when the hole lines up with the pin. The rod is further held in place by item 432 which can be a D-ring assembly where the ring lays in the cup when not in use. In use the rod 433 crosses over the top of the chair or stool's cross rungs.

The purpose of the rod 433, block 430, and D-ring 432 is to put downward pressure on the cross rungs of a stool or chair which is positioned behind the bike for recumbent riding. The chair cannot tip backward, nor can the bike creep forward under conditions of aggressive pedaling. However, the chair or stool can be easily repositioned to account for varying lengths of riders' legs and to increase or decrease knee flexion during rehab.

The plate 420 can be a sheet of resin, wood, or metal. In the pictured embodiment it is bolted to the bike's back foot with the vertical bolts 411. In another embodiment 410 represents an L attached to the front edge of plate 420, and the dotted FIG. 405 represents the bike's back foot. Thus, 410 can be bolted to the front side of the back foot with horizontal bolts represented by 412.

The two slits 421 in the bottom plate permit straps, ratcheting or any other type, to tie down the front wheels of a wheelchair to ensure the front of the wheelchair does not rise up with aggressive pedaling.

It is also possible to place the back of the chair or wheelchair against a wall and bring the bike to it, without the use of the afore-described plate. The front of the chair will not lift with aggressive pedaling. However, the bike can creep forward and thus should be immobilized with a rubber door stopper or similar means.

Important aspects of the claimed invention include the variable elevation of the upper lever arms that permit recumbent and vertical riding modes, lever arm length extensions, handle rotation, the dimensions of the boom that permit the media platform to be positioned in the appropriate distance and direction from the rider's head, the means of adjusting the pedal crank length, and immobilizing the chair or wheelchair.

Boom or Adjustable Platform

Aspect of the invention: An adjustable boom or articulated arm supporting a media tray for presenting digital and print media to the rider. The boom can be rotated to place the media tray on one side of the device or the other. A hinge allows the angle of the arm holding the media tray to be increased or decreased. A telescoping member of the boom can be lengthened or shortened as required to position the media tray within the reach of the rider or outside it. If the media tray is placed within reach of the rider, he/she can interact with a computer via a keyboard or directly with a touch screen. The purpose of the wide range of movement of the adjustable platform is to encourage specific placement of the rider's head during therapy and therapeutic exercise of either upper extremity including cross-body reaching.

Five-Way Adjustable Lever Arms

Aspect of the invention: The linking mechanism between the pedals and lever arms is immaterial to this aspect of the invention. (1.) A set screw and snap button or quick-connect clamp allow the entire arm assembly to be raised and lowered at least 2-4 inches; (2.) A hinge with locking detents every 10 degrees is incorporated into the lever arm between the upper and lower arm assemblies to permit the handle elevation to be altered in an arc comprising about 220 degrees. The hinge surfaces are marked with a relative scale and marker to indicate the position of the hinge for repeatability; (3.) The length of the arm is variable by use of a telescoping member which is secured by a set screw, snap button, or quick-release clamp. Telescoping members of varying length can be interchanged to facilitate vertical and recumbent riding modes. (4.) The handles as the bent portion at the end of the telescoping arm can be rotated, in one embodiment, by rotating the entire telescoping element and fixing it with the aforementioned quick-release clamp.

Adjustable Pedal Arm Length

Aspect of the invention: The pedal is attached to a block that slides along the pedal crank arm. The crank arm is drilled at regular intervals to provide varying pedal crank arm lengths and corresponding stroke diameters, from about 3″ for small children and beginning knee and hip rehabilitation patients, to about 6″ for adults and full stroke rehabilitation. The block can be secured to the crank arm by one or more means to ensure it does not slip.

Vertical-Recumbent Riding Positions

Aspect of the invention: The recumbent riding position is vital for riders who do not have the core strength to remain seated on a vertical riding seat, who do not have the strength in their legs and sufficient balance to step up to and remain on the vertical seat, who may be recovering from knee or hip surgery or are precluded in some manner from stepping up or over and onto a vertical seat, or who may be restricted to a wheelchair. Stationary fitness bikes are divided into step-through and step-over designs.

The claimed invention permits recumbent riding by first replacing the short extension arms 116 with the long recumbent arms 117 (FIG. 1). The seat can be removed from its mount. The wheelchair (or chair) is then drawn up to the back of the bike, the rider's feet placed on the pedals, and the chair positioned to obtain the optimum extension of the rider's legs or desired maximum flexion of one or both knees. The wheelchair's wheel lock is clamped down, and it (or chair) is then fastened to the recumbent riding platform that is attached to the bike's rear foot. The platform and tie-downs serve to prevent two movements that can occur when riding. The first is a pair of mutually opposed lateral displacements, one of the bike in the forward direction and the counter motion of the rider's chair in the backward direction. The other is the lifting motion of the bike's back foot and related lifting motion of the front of the rider's chair. These typically do not occur unless the rider is aggressively pedaling with a high resistance and not using the lever arms, which circumstances are not found in rehab situations.

Although the present invention has been described with respect to a specific preferred embodiment thereof, various changes and modifications may be suggested to one skilled in the art and it is intended that the present invention encompass such changes and modifications as fall within the scope of the appended claims. 

We claim:
 1. An exercise apparatus, comprising: a frame; a left arm assembly and a right arm assembly, each supported by the frame and configured to enable pivoting movement of the left arm assembly and right arm assembly relative to said frame; a left pedal assembly and right pedal assembly, oppositely placed and extending in opposite directions, each supported by the frame and configured to enable rotational movement about a central pivot axis; a drive mechanism supported by said frame and configured to enable contralateral movement of the left arm assembly relative to the right pedal assembly, the right arm assembly relative to the left pedal assembly, and of the right arm assembly relative to the left arm assembly; wherein said left arm assembly and right arm assembly are adjustable to enable use of said exercise apparatus in both an upright seating configuration and a recumbent seating configuration.
 2. The exercise apparatus of claim 1, further comprising a moveable seat, wherein: in a first seat position said moveable seat is positioned to accommodate a user in the upright seating configuration, and in a second seat position said moveable seat is moved to a position enabling a user to use said exercise apparatus in the recumbent seating configuration while seated in a chair, wheelchair, or scooter positioned behind said exercise apparatus.
 3. The exercise apparatus of claim 2, wherein in said second seating position said moveable seat is removable from said exercise apparatus.
 4. The exercise apparatus of claim 2, wherein the left arm assembly and right arm assembly are adjustable to increase their effective length when the exercise apparatus is set in the recumbent seat configuration.
 5. The exercise apparatus of claim 4, wherein the left arm assembly and right arm assembly each comprise a 5-point adjustable lever arm adjustable in translational, rotational, and extendible dimensions.
 6. The exercise apparatus of claim 5, wherein each 5-point adjustable lever arm comprises an upper lever arm and a lower lever arm, and wherein an angle of the upper lever arm with respect to the lower lever arm is adjustable by use of a hinge with at least 220 degrees of movement.
 7. The exercise apparatus of claim 6, wherein each of said left arm assembly and right arm assembly can be independently rotated towards the front of the exercise apparatus to a position beyond the reach of a user.
 8. The exercise apparatus of claim 2, further comprising: an adjustable boom coupled to said frame; and a media platform coupled to said adjustable boom; wherein said adjustable boom and media platform are adjustable to locate media placed upon said media platform in positions facilitating desired head-placement of a user via interaction by said user of media placed thereon, and therapeutic exercise of either upper extremity including cross-body reaching.
 9. A method for performing multiple repetitions of therapeutic actions in a clinic or home situation with minimal intervention by a therapist, comprising the provision, for use by a patient, of: an exercise apparatus, comprising: a frame; a left arm assembly and a right arm assembly, each supported by the frame and configured to enable pivoting movement of the left arm assembly and right arm assembly relative to said frame; a left pedal assembly and right pedal assembly, oppositely placed and extending in opposite directions, each supported by the frame and configured to enable rotational movement about a central pivot axis; a drive mechanism supported by said frame and configured to enable contralateral movement of the left arm assembly relative to the right pedal assembly, the right arm assembly relative to the left pedal assembly, and of the right arm assembly relative to the left arm assembly; wherein said left arm assembly and right arm assembly are adjustable to enable use of said exercise apparatus in both an upright seating configuration and a recumbent seating configuration, and wherein the patient: selects a seating configuration; engages said left and right arm assemblies with his/her hands; engages said left and right pedal assemblies with his/her feet; and engages the drive-mechanism to perform said multiple repetitions.
 10. The method of claim 9, wherein the exercise apparatus further comprises: a moveable seat attached to said frame, wherein: in a first seat position said moveable seat is positioned to accommodate a user in the upright seating configuration, and in a second seat position said moveable seat is moved to a position enabling a user to use said exercise apparatus in the recumbent seating configuration while seated in a chair, wheelchair, or scooter positioned behind said exercise apparatus.
 11. The method of claim 10, wherein in said second seating position said moveable seat is removable from said exercise apparatus.
 12. The method of claim 10, wherein the left arm assembly and right arm assembly are adjustable to increase their effective length when the exercise apparatus is set in the recumbent seat configuration.
 13. The method of claim 12, wherein the left arm assembly and right arm assembly each comprise a 5-point adjustable lever arm adjustable in translational, rotational, and extendible dimensions.
 14. The method of claim 13, wherein each 5-point adjustable lever arm comprises an upper lever arm and a lower lever arm, and wherein an angle of the upper lever arm with respect to the lower lever arm is adjustable by use of a hinge with at least 220 degrees of movement.
 15. The method of claim 14, wherein each of said left arm assembly and right arm assembly can be independently rotated towards the front of the exercise apparatus to a position beyond the reach of a user.
 16. The method of claim 10, wherein said exercise apparatus further comprises: an adjustable boom coupled to said frame; and a media platform coupled to said adjustable boom; wherein said adjustable boom and media platform are adjustable to locate media placed upon said media platform in positions facilitating desired head-placement of a user via interaction by said user of media placed thereon, and therapeutic exercise of either upper extremity including cross-body reaching.
 17. The method of claim 9, further comprising adjusting the lever arms in at least one of five translational, rotational, and extendible dimensions to fit the patient's size and specific therapy.
 18. The method of claim 17, wherein an angle of the upper lever arms with respect to the lower lever arms is adjustable by use of a hinge with at least 220 degrees of movement.
 19. The method of claim 13, wherein the extendible portion of the lever arms is composed of alternatively short or long pieces, 17″-48″, defined for vertical or recumbent riding, respectively, for children or adults, or for special therapies.
 20. The method of claim 13, where in the lever arms can be removed, can be rotated inward for cross-body therapeutic movements, and can be rotated to be used independently of the pedals and so that the pedals can used independently of the lever arms.
 21. The method of claim 16, wherein the boom can be adjusted in at least 4 translational, rotational, and extendible dimensions to fit patients of varying size, disposition, and therapeutic need, specifically for head placement therapies and reaching activities with either hand, while also enabling convenient location for interacting with the media.
 22. The method of claim 21, wherein a media platform fixed to the end of the extendible boom arm can be adjusted in at least 4 translational, rotational, and extendible dimensions to permit fine adjustments of the presentation of a range of print and digital media to the patient.
 23. The method of claim 9, wherein the pedals are fixed to blocks which slide along a pedal arm which has been designed with drillings at dimensions specifically to permit adjustment of the pedal crank arm length from about 3″ to about 6″ for therapies which require increasing stroke of the knee and hip, which block is fixed to the pedal by at least one means.
 24. The method of claim 13, wherein the vertical and recumbent riding positions are interchangeable by removing or replacing the short and long extendible portions of the lever arms and adjusting the angle with the hinge.
 25. The method of claim 9, wherein recumbent riding is accommodated by removing the standard seat and alternatively placing it in a fixture attached to the back of the bike or by locking a wheelchair in place behind or by using an appropriate chair.
 26. The method of claim 9, wherein the rotational properties of the arm-pedal mechanism control digital media screen visual and audio properties, according to target ranges of rpm, to give feedback to the patient, to stress the patient's brain and to train it.
 27. The method of claim 9, wherein mechanical riding data such as rpm, duration, distance, and number of times the screen is turned off, are wirelessly communicated to a land- or cloud-based server in the specific patient's file for review and monitoring by a medical professional.
 28. The method of claim 9, wherein the patient's physiological data (such as pulse, blood oxygen, and others) before, during, and after the ride are wirelessly communicated to a land- or cloud-based server in the specific patient's file for review and monitoring by a medical professional.
 29. The method of claim 9, wherein a medical professional can set up a video and audio link to monitor the patient's riding in a virtual home visit.
 30. The method of claim 13, wherein the extended lever arms can control the movement of the pedal forward and backward in cycles and around the pedal rotation to facilitate range of motion therapy for knee rehab therapy.
 31. The method of claim 9, wherein specific therapies for disabilities are described, including timing, pace/cadence, set up of the arms, boom, and pedal crank arm length, placement of the head, arms, and legs, and duration of the treatment cycle, among many others. 